Katzenwadel A, Popken G, Buitrago-Téllez C H, Schultze-Seemann W, Langer M, Sommerkamp H
Department of Urology, University of Freiburg, Germany.
J Endourol. 1995 Dec;9(6):433-8. doi: 10.1089/end.1995.9.433.
In 50 patients treated for urolithiasis by extracorporeal shockwave lithotripsy (ESWL++), the radiographs taken before and 1 day afterward were initially assessed by conventional radiography and subsequently after standardized digitization and postprocessing. Clinical outcome and passage of stone fragments were reevaluated 3 weeks after ESWL. Using specially developed software routines, new disintegration parameters could be obtained by detecting the number of relevant minima in light-intensity distribution along the length axis of the concrement in digitized images. Comparing the digitized images before with those after ESWL, the concremental surface and axial length in digitized images on average showed no statistically significant difference. However, the number of visually and automatically detected light-intensity minima of the concrement region in digitized images obtained 1 day after ESWL was significantly higher than prior to ESWL and correlated significantly with the number of fissure lines in the conventional images. These new features in digitized images showed a high sensitivity in predicting later passage of stone fragments. Moreover, in six of the seven patients without detectable fissure lines in the early conventional radiographs but obvious signs of concretemental disintegration 3 weeks after ESWL, there was an increase in the number of light-intensity minima in the digitized images 1 day after ESWL. Our findings indicate that this method of digitization and post-processing of radiographs may improve the assessment of ESWL effectiveness by improving standardization in the analysis of all surveyed parameters and by offering new relevant disintegration measures.
在50例接受体外冲击波碎石术（ESWL++）治疗尿路结石的患者中，术前和术后1天拍摄的X光片最初通过传统放射摄影进行评估，随后经过标准化数字化和后处理。ESWL术后3周重新评估临床结果和结石碎片的排出情况。使用专门开发的软件程序，通过检测数字化图像中结石沿长轴的光强分布中相关最小值的数量，可以获得新的碎石参数。将ESWL术前和术后的数字化图像进行比较，数字化图像中结石的表面和轴向长度平均无统计学显著差异。然而，ESWL术后1天获得的数字化图像中结石区域视觉和自动检测到的光强最小值数量明显高于ESWL术前，且与传统图像中的裂隙线数量显著相关。数字化图像中的这些新特征在预测结石碎片的后期排出方面具有很高的敏感性。此外，在7例早期传统X光片未检测到裂隙线但ESWL术后3周有明显结石崩解迹象的患者中，有6例在ESWL术后1天数字化图像中的光强最小值数量增加。我们的研究结果表明，这种X光片数字化和后处理方法可能通过提高所有测量参数分析的标准化程度以及提供新的相关碎石测量方法来改善对ESWL疗效的评估。
